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قناة طبيه تهتم بالكتب الطبيه واي شي۽ متعلق بالطب #BRS #pathoma @Yaqob_alsomaii
👨⚕Why you will examine abdomen in patient with anemia ?
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👨⚕Q. What are the causes of macrocytic anemia?
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👨⚕ Q. What are the causes of microcytic hypochromic anemia?
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👨⚕ Q. What are the causes of normocytic normochromic anemia?
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Cardiovascular System
✓ There is a systolic murmur in the apical area (likely to be flow murmur)
Simply its cause is unknown , but some cases may have underlying cause as multiple sclerosis , tumer in cerebllopontine angle
How to Diagnosis?
Diagnostic criteria:
✓Recurring unilateral face pain✓Pain characteristics:Severe, no more than Two minutes ,
✓ Quality: sharp, shooting, stabbing, or electric shock-like✓Triggered by innocuous stimuli in the area innervated by the affected trigeminal nerve divisions
✓ other diagnosis not explainby symptom
So it's diagnosis is clinically
When i will use MRI ?
Only When i sugges patient has secondary casue as MS , and tumer by their clinical pictures
Treatment :
Carbamazepine " 100 mg PO twice Dailey
For acute exacerbations :
lidocaine infusion : 5 mg/kg IV over 60 minutes
If you don't do mistake here you will do it in your patient 😞
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Experience is simply the name we give our mistakes
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Trigeminal neuralgia, or tic douloureux, is a condition characterized by attacks of facial pain in the area of one or more branches of the trigeminal nerve.
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Answer of the above case :
a. Pseudohypoxemia due to oxygen consumption by high TLC.
b. Analyze sample immediately after drawing or send the sample on ice
A 5-year-old male child is recently diagnosed as a case of acute myeloid leukemia. He is clinically stable with a RR of 20/min, normal
blood pressure and SpO2 of 95% in room air. His blood gas is as follows:
pH–7.43; PaCO2–34 mmHg; PaO2–47.6 mmHg; HCO3
-–24 mEq/L.Further investigations show leucocytosis (TLC—60,000/cu mm) and anormal chest X-ray.
a. Analyze the blood gas report.
b. What step will you take to improve PaO2 in this patient?
If you want us to continue write cases , questions, discussion ?
React to know you understand or not
🧑⚕
1. Macrocytosis with megaloblastic marrow are found in:
✓ Vitamin B12 deficiency
✓ Folic acid deficiency.
2. Macrocytosis with normoblastic marrow are found in:
✓ Chronic liver disease
✓ Chronic alcoholism
✓ Hypothyroidism
✓ Hemorrhage
✓ Hemolysis
✓ Others—sideroblastic anemia, pure red cell aplasia, azathioprine therapy
🧑⚕ Answer:
✓ Iron deficiency anemia
✓ b-thalassemia major
✓ Sideroblastic anemia
✓ Anemia of chronic disorder (ACD).
🧑⚕ Answer :
✓ Anemia of chronic disorder
✓ Chronic infection (e.g. tuberculosis)
✓ Collagen disease (e.g. SLE, rheumatoid arthritis)
✓ Malignancy
✓ Endocrine disease
✓ Sideroblasitic anemia
Answer :
Morphological (depending on MCV and MCHC):
1. Normocytic normochromic anemia (normal MCV and MCHC).
2. Microcytic hypochromic anemia (low MCV < 76 fl, low MCHC < 30 g/dl).
3. Macrocytic anemia (high MCV > 96 fl).
4. Diamorphic anemia (two cell lines—macrocytes and microcytes)
🧑⚕answer ✓ aetiological classification :
1. Hemorrhagic anemia (due to blood loss)
2. Dyshemopoietic anemia (due to inadequate production of RBC):
✓ Deficiency anemia—Iron, vitamin B12, folate deficiency.
✓ Aplastic anemia (bone marrow failure which may be primary or secondary to some other
diseases or drugs).
✓ Anemia of chronic disorder (ACD)—SLE, rheumatoid arthritis, CRF.
✓ Other Hypothyroidism, sideroblastic anemia, malignancy.
3. Hemolytic anemia:
✓Genetic—Red cell membrane defect (e.g. hereditary spherocytosis, eliptocytosis,
stomatocytosis), hemoglobin abnormality (thalassemia, sickle cell anemia) or enzyme defects
(glucose-6-phosphate dehydrogenase deficiency, pyruvate-kinase deficiency).
✓ Acquired—Autoimmune, toxic, mechanical and infectious causes.
Answer :Anemia is a clinical condition characterized by reduced hemoglobin concentration, which is
usually but not invariably associated with reduced RBC
Name. …, ? years old, work , normotensive, nondiabetic, nonsmoker, hailing from …, presented with severe weakness for … months, which is gradually worsening and now she finds it difficult to perform regular daily activities. For the last … months, she also experiences occasional dizziness, light-headedness, tingling and numbness in both feet and occasional cramps in calf muscles. The patient also complains of palpitation, loss of appetite and weight loss for … months. There is no history of fever, difficulty in swallowing, bleeding from any sites or menorrhagia and bowel or bladder abnormality. The patient was treated by local physicians with iron tablets, multivitamin and ranitidin. There is no family history of similar illness
Examination: as above
Anemia
Chief complaints
✓ Weakness for … months
✓ Occasional dizziness for … months
✓ Tingling and numbness in lower limbs for … months
✓ Anorexia, weight loss and palpitation for … months.
History
History present illness: The patient states that she was alright … months back. Since then, she has
been suffering from severe weakness which is gradually worsening and now she finds it difficult to
perform regular daily activities. For the last … months, she also experiences occasional dizziness,
light-headedness, tingling and numbness in both feet and occasional cramps in calf muscles. The
patient also complains of palpitation, loss of appetite and weight loss for … months. There is no
history of fever, difficulty in swallowing, bleeding from any sites or menorrhagia and bowel or bladder
abnormality.
History of past illness
Family history
Personal history
Menstrual history
Socioeconomic history
Drug history: Mention according to the patient’s statement.
General examination
✓ The patient looks pale
✓ Moderately anemic
✓ No jaundice, clubbing, cyanosis, koilonychia, leukonychia or edema
✓ No lymphadenopathy or thyromegaly
✓ Sternal tenderness: Absent
✓Pulse: 120/min.
✓ BP: 95/65 mm Hg
#long_case
Trigeminal neuralgia more in female old age ,
What is the cause of trigeminal neuralgia ?
How to diagnose?
What is the DD ?
What is the treatment ?
''Making mistakes simply means you are learning faster."
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If you try to answer any questione or case it is a good thing , so if your answer is false it's not a problem , don't delete or Do not be ashamed
Learn from your false answer its better than your silent
35-year-old woman comes to the emergency department because of a 3-day history of pain in the left cheek. The pain occurs every few hours, lasts 30–60 seconds, and is aggravated by chewing and brushing. She has a history of pain with a vesicular rash in the right axillary area 1 year ago. She had an upper respiratory infection 2 weeks ago. Physical examination shows no abnormalities. What's the most likely diagnosis ?
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It's Very interested case , When I read it on the first time , its answer was surprise
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